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Renal function in children with hypercalciuria

N Tekin1, N Kural, M Torun

  • 1Department of Pediatrics, Osmangazi University Faculty of Medicine, Eskişehir.

The Turkish Journal of Pediatrics
|July 1, 1997
PubMed
Summary
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Children with hypercalciuria often show normal renal function but may have subtle tubular injury. Urinary N-acetyl-beta-D-glucosaminidase (NAG) is a sensitive marker for detecting this renal tubular injury in pediatric hypercalciuria cases.

Area of Science:

  • Pediatric Nephrology
  • Renal Physiology
  • Biomarker Discovery

Background:

  • Hypercalciuria is a common pediatric condition linked to abdominal pain, hematuria, enuresis, and kidney stone formation.
  • It arises from either a renal tubular calcium leak or increased intestinal calcium absorption.
  • Assessing renal functional impairment in children with hypercalciuria is crucial for understanding potential long-term consequences.

Purpose of the Study:

  • To investigate the presence of renal functional impairment in children diagnosed with hypercalciuria.
  • To evaluate the utility of urinary N-acetyl-beta-D-glucosaminidase (NAG) as a sensitive marker for renal tubular injury in this population.

Main Methods:

  • Screened 298 children for hypercalciuria using the urinary calcium/creatinine (UCa/UCr) ratio.

Related Experiment Videos

  • Evaluated renal function in 18 children with hypercalciuria (UCa/UCr > 0.18) and compared them to a healthy control group.
  • Measured creatinine clearance, osmolar and free water clearances, fractional sodium excretion, tubular phosphorus reabsorption, and urinary NAG excretion.

    • Main Results:

    • Hypercalciuria was detected in 6.4% of the screened children, with significantly higher daily calcium excretion compared to controls.
    • Standard renal function tests (creatinine, osmolar/free water clearances, fractional sodium excretion, tubular phosphorus reabsorption) showed no significant differences between hypercalciuric children and controls.
    • Urinary NAG excretion, normalized for creatinine, was significantly elevated in children with hypercalciuria, indicating tubular injury.

    Conclusions:

    • Children with hypercalciuria typically exhibit normal overall renal function based on conventional tests.
    • Urinary NAG is a sensitive biomarker for detecting subclinical renal tubular injury in pediatric hypercalciuria.
    • NAG measurement offers a valuable tool for identifying early tubular damage in children with hypercalciuria, even with normal renal function studies.